50 years ago in the journal of pediatrics: Natural history of ventricular septal defects in childhood lesions with predominant arteriovenous shunts

摘要

This large study followed the natural history of ventricular septal defects (VSDs) in infants and children in 1964. The subjects were divided into 3 groups based on history, physical examination, and chest radiography findings. Patients in group 3 were diagnosed with congestive heart failure (CHF) and pulmonary hypertension (PHTN).Only patients in this latter group were considered for cardiac catheterization. Closure of the defect was not recommended in infancy unless the CHF could not be managed with medical treatment or if the PHTN was considered severe. The mortality rate associated with surgery was very high, and thus surgery was recommended only as a last resort. Conventional treatment for CHF included antibiotics to treat infections early and aggressively, digitalis, oxygen tents, and low-salt formulas.